This is an outdated version published on 29.12.2023. Read the most recent version.

Evaluation of risk factors for incidental parathyroidectomy during thyroidectomy

Evaluation of risk factors for incidental parathyroidectomy during thyroidectomy

Authors

  • Çağrı Büyükkasap Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Türkiye
  • Aydın Yavuz Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Türkiye
  • Hüseyin Göbüt Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Türkiye
  • Kürşat Dikmen Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Türkiye
  • Hasan Bostancı Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Türkiye

Keywords:

Incidental, parathyroidectomy, thyroidectomy, hypocalcemia

Abstract

Objective: Hypocalcemia remains a common problem after thyroidectomy. One of the most common causes of this condition is incidental parathyroidectomy. This study aimed to evaluate the risk factors for incidental parathyroidectomy and the clinical outcomes of incidental parathyroidectomy in patients undergoing thyroidectomy.

Methods: A retrospective analysis was conducted on 817 patients who underwent thyroidectomy at the Department of General Surgery at Gazi University between January 2015 and June 2022. Medical records were reviewed for demographic, pathological, and clinical variables. The primary outcome measure was the factors affecting incidental parathyroidectomy, and the secondary outcome measure was the clinical results of incidental parathyroidectomy.

Results: Adding lymph node dissection to thyroidectomy statistically increased the frequency of incidental parathyroidectomy (p<0.001). The incidence of incidental parathyroidectomy was significantly higher in patients whose final diagnosis was malignant (p=0.006). Considering some characteristics of the malignant group, extrathyroidal spread, lymphatic invasion, vascular invasion, and positive surgical margins were not statistically significant for incidental parathyroidectomy. Post-operative calcium levels were statistically significantly lower in the incidental parathyroidectomy group (p<0.001). The incidental parathyroidectomy group had a significantly higher incidence of post-operative biochemical hypocalcemia (calcium level <8.5 mg/dL) (p<0.001).

Conclusion: Incidental parathyroidectomy may occur during total thyroidectomies. This situation increases with thyroidectomies performed for malignant reasons and lymph node dissection. Moreover, although incidental parathyroidectomy causes post-operative biochemical hypocalcemia, its effect on symptomatic hypocalcemia is low.

Downloads

Published

29.12.2023

Versions

Issue

Section

Original Research

Most read articles by the same author(s)